Data-Driven DEI™ Case Study: MetroHealth System
The MetroHealth System is a 187-year-old healthcare provider located in Cleveland, OH, that operates four hospitals and emergency departments, 40 health centers, and 20 satellite sites throughout Cuyahoga County. They report approximately 1.5 million patient visits annually, the majority of whom are people of color who are either uninsured or covered by Medicare or Medicaid.
According to Alan K. Nevel, Senior Vice President and Chief Equity Officer at MetroHealth, “The premise and foundation of our vision and mission, since we opened our doors almost 190 years ago is that we will take care of you, regardless of how sick you are or your ability to pay and have never wavered from our mission or vision since.” Committed to remaining a safety-net for the Cleveland community, MetroHealth has tackled issues beyond access to care and disparities in treatment including housing/food insecurity and workforce development to address inequities typically experienced in low-income, urban areas. However, over time they also realized the myriad of well-intentioned programs initiated through their system were not having the impact or the wide-spread benefit intended. Instead of making a difference in tens of thousands of lives, they were touching just a few hundred through numerous one-off initiatives. And, despite serving and employing a population whose combined makeup was over 75% Black and Brown people, equity, inclusion, diversity and equality (EID) were still significant challenges within the organization that required more targeted attention. According to Nevel, the urgency of their imperatives intensified following George Floyd’s murder and illuminated the severe effect disparate treatment had on people of color.
Taking a step back to assess how they could increase cross-industry and cross-sector relationships between for-profit and non-profit enterprises to more impactfully benefit their communities, MetroHealth leadership decided to create what they describe as a movement, to address the overall wellness and quality of life of underserved populations marginalized by systemic racial inequality. They began this endeavor by creating the following nine aspirational EID goals to improve access to opportunities:
Sense of belonging
Eliminating mental and physical health disparities
However, what really set MetroHealth apart from its healthcare system peers is their hand-on approach to and use of data as a driver to action. Data is the catalyst that identifies need areas and outcomes are measured in changed behavior or visible health and life improvements.
For example, with respect to eliminating mental and physical health disparities, MetroHealth utilizes REAL (Race, Ethnicity and Language) data collection with patients to obtain accurate demographic information and establish a baseline. National health quality data indicated that, historically, Blacks and Hispanics received 40% worse care than whites. So, obtaining information on the specifics of the local population and their healthcare experiences was key to measuring successful implementation of best practices.
Nevel added, “It goes beyond medicine for us. We consider the total person and everything affecting their life quality. We saw that food and housing insecurity were factors in health quality, so we partnered with a developer and built an innovative mixed-use project – called Vía Sana, or ‘Healthy Way’ that will feature 72 one-bedroom, two-bedroom, and three-bedroom affordable apartments. These quality homes have been priced well within the capacity of low-income households and we also created guidelines to help overcome obstacles in the purchase process. It will also feature the MetroHealth Economic Opportunity Center, which will offer job training, financial, and digital literacy training and access to classes from Cuyahoga Community College. With regard to food issues, if diagnostic exams indicate nutrition deficiencies, we can literally write a prescription for fruits and vegetables that can be filled in local markets. And, by making equity a focal point at every stage of the hiring process, about 45% of all new hires, and 30% of new care providers in 2021, were underrepresented minorities. These are tangible results. At MetroHealth, data drives us to action and those actions have a direct and positive impact on lives.”
Additionally, in support of their anti-bias initiative, they launched an immersive employee education effort to explore how the human brain naturally holds stereotypes and biases. This work leveraged the Rali Change Experience (CX) platform, a comprehensive and advanced digital engagement system for content, coaching, and community. Coupled with intelligent data analytics, Rali translates interaction into valuable insight, helping organizations realize a faster time to impact and lasting change. Partnering with Rali, MetroHealth made unconscious bias training mandatory for all employees, which earned a 97% positive reception rate since inception. Empathetic listening sessions via staff/patient focus groups and community open mics to gather additional qualitative data were also initiated. This made certain that decision making was inclusive of direct human perspectives, and not just numbers on paper, and that patient concerns, which were rooted in past medical atrocities, were addressed with compassion and patience.
“What we're faced with now is creating equity for all, and by all, I mean our patients, our employees and the greater community. We have a moral stewardship and responsibility to address disparities in our community and eradicate historical and systematic barriers to provide quality healthcare to all,” says Nevel. “MetroHealth is committed to racial equity and inclusion and enhancing the culture by building a foundation of training that examines the history and the impact of race, racism and the importance of fostering cultural competency. We accomplish this in part through the education of employees across the system and strive to sustain a culture of inclusion, diversity, and equity in the workforce to improve the wellbeing of the patients and the communities we serve.”